Introduction
Workforce development is important in order to develop a sustainable public health system over time. A highly qualified public health workforce should be developed and maintained with appropriate technical training, scientific skills and subject-matter expertise.
Target
State Parties to have skilled and competent health personnel for sustainable and functional public health surveillance and response at all levels of the health system, and the effective implementation of the IHR (2005).
Slovenia level of capabilities
For all IHR functions, human resources are available including primary health care and medical specialists;
epidemiologists; microbiologists and other scientists; veterinarians; and sanitary engineers. The NIPH team is dedicated, motivated and well trained. Currently the country has 11 epidemiologists at national level and 14 at regional level, with six trainees in public health at regional level. This is currently sufficient, but it is a vulnerable situation.
At national level, staff members are responsible for many functional areas simultaneously, with very little back-up. Imminent retirement of staff members in the coming years means a staff shortage is imminent. There is no career structure in place for effective replacement and retention of eligible and qualified candidates.
There is a well-established medical specialization in public health, requiring four years of training. This specialization offers generic training in public health with relevant parts dedicated to communicable disease control. Specialists are licensed by the Slovenian Medical Chamber, with renewal of licensing every seven years.
Clear rules are in place for continuous professional development. There is a mechanism for annual workforce planning for medical specialists, including for public health. A specific strategy for the communicable disease control workforce (relevant for IHR), based on a needs assessment, is yet to be developed. Medical specialization programmes in microbiology and infectious diseases are well established, with an annual strategy for workforce planning. For veterinarians, public health is (a small) part of the education programme.
Part of the training for the specialty in public health can be seen as intermediate-level FETP. Next to this, Slovenia has a yearly seat on the Member State track of the EPIET programme provided by ECDC. In the past, two medical doctors in public health followed the EPIET programme; currently one colleague is in the programme. There is no school for public health in Slovenia, but collaboration with schools for public health in neighbouring countries or through the Association of Schools for Public Health in the European Region (ASPHER) could offer possibilities.
Importantly, Slovenia maintains a very strong training programme for sanitary engineers, which is a four-year degree that covers epidemiology, general hygiene principles, environmental topics, and data management.
For nurses, there is also additional training focused on hospital hygiene, though no programmes exist to expand further beyond more traditional nursing roles (e.g. programmes for community health nursing, or public health nurse practitioners).
of IHR Core Capacities of the Republic of Slovenia
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Recommendations for priority actions
• Develop a comprehensive, multidisciplinary public health workforce policy to address targets based on national priorities and international requirements, with strategies for recruitment, training and retention.
• Develop a clear career structure to ensure effective replacement and retention of eligible and qualified public health candidates.
• Utilize training opportunities available in neighbouring countries and the EU, to supplement the workforce through regional collaboration.
• Develop positions for other types of public health professionals, including Masters-level specialists, social scientists, and health information technologists.
Indicators and scores
D.4.1 Human resources are available to implement IHR core capacity requirements – Score 4 Strengths/best practices
• Human resources are available including primary health care and medical specialists; epidemiologists;
microbiologists and other scientists; veterinarians; and sanitary engineers.
• Training programmes are of high quality and are conducted at the national universities.
• Capacity to implement IHR core requirements is available at both national and regional levels.
• There is strong professional networking at national and regional levels.
• There is timely exchange of knowledge and practices, through weekly videoconferences and monthly epidemiological meetings.
Areas that need strengthening/challenges
• Training options are required for a multidisciplinary workforce, and to generate and sustain intermediate-level professionals in multiple disciplines including public health, community nursing, biostatistics and social science.
• Funding constraints result in attrition of the public health workforce due to limited career opportunities.
• Training in risk communication needs to be integrated into the curricula for training and continuous professional development for all public health professionals.
• To ensure the workforce is sustainable for the future, working conditions and payment should be attractive to young professionals from multiple disciplines.
D.4.2 Field epidemiology training programme or other applied epidemiology training programme in place - Score 3
Strengths/best practices
• The current education programme for medical specialists in public health is of high quality and well-established, with strong elements of an FETP programme for communicable disease control at intermediate level.
• The available EPIET training programme is utilized, offering Slovenia a yearly seat in the Member State track.
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Areas that need strengthening/challenges
• Training options are lacking for a multidisciplinary workforce. Training is required for intermediate professionals in multiple disciplines such as public health, community nursing, biostatistics and social science.
• Further use should be made of training opportunities in neighbouring countries and the EU, to supplement workforce collaboration.
D.4.3 Workforce strategy - Score 3 Strengths/best practices
• The medical education programme is well-established. There is a mechanism for forecasting the workforce for medical and public health specialists, with a legal demand for continuous education (via a licensing procedure).
Areas that need strengthening/challenges
• A comprehensive multidisciplinary public health workforce policy must be developed, in order to address specific public health workforce targets based on national and international requirements, priorities and needs. This policy must address capacity building for various cadres in the areas of strategies for training, recruitment, and retention.
• A better developed career structure is needed, to ensure the effective replacement and retention of eligible and qualified public health candidates.
• Other disciplines should be attracted to the public health workforce as well as medical doctors—such as holders of Masters in Public Health, social scientists, and biostatisticians.
of IHR Core Capacities of the Republic of Slovenia